Over the past few months we have seen the nursing organisations express great concern at the increase in the retention fee by the nursing board, from €100 to €150. This has been an ongoing situation for some time and has been highlighted by political parties, advocacy groups, patient groups and the nursing organisations. A 50% increase in any fee is an extraordinary demand, particularly when coupled with the fact that payment is mandatory for registration. The fee is payable to the registration board and under law nurses must register with the board. Therefore, nurses have no choice. If they want to practice in this country, they must register with the board. No reason or rationale was provided for the increase in the fee, other than that the board says it must continue with significant changes in the fitness to practise area, which include the introduction of a new preliminary proceedings committee, and the fact that it needs to upgrade its systems as continuing professional development will become a mandatory requirement for nurses and midwives. This is the only reason the board has give for increasing the registration fee from €100 to €150.

We all know that people on front-line services are under extraordinary pressure in delivering health care to patients. The least that should happen is that there should be engagement between the board and the organisations representing the nurses to ensure we have a registration system that is fair, professional and affordable. It is unacceptable that any fee could be increased by 50% without reason.

Our straight talking Minister for Health claims he "says it as he sees it". On this occasion, he wrote to the board asking it to engage with the nursing organisations. However, there has been no activity from either the Minister or the board in an effort to provide engagement. Will the Tánaiste therefore take up the cudgel for the nursing organisations and ask the board to engage in a meaningful way with them?

On 17 September 2014, the Nursing and Midwifery Board of Ireland, NMBI, voted to increase the annual registration fee for nurses and midwives, from €100 to €150 for 2015. I agree this is a large increase, particularly at a time when the danger to the eurozone is not inflation but the risk of deflation.

The staff associations have undertaken a campaign against paying the new fee and have advised members to pay the old fee of €100. Potentially, nurses who do not pay the appropriate fee will be removed from the register. As the Deputy said, in order to resolve this issue we need negotiation, discussion and consultation so as to reach an agreement. I know and have spoken with nurses who have found this a significant increase, in particular in a situation where their budgets are stretched.

Officials from the Department of Health have written to and met the president of the Nursing and Midwifery Board of Ireland on a number of occasions - two meetings took place in December 2014 - and they expressed concern about the possible implications for the health services and patient safety if this situation should lead to some form of industrial dispute which would have an impact on patients. The board met the staff associations and the matter was discussed at board meetings. However, I am conscious the issue has not yet been satisfactorily resolved. The Minister for Health continues to monitor the situation closely and has asked the board and staff associations to continue discussion. I cannot report a satisfactory outcome to the Deputy as yet.

There is a crisis in our health services as well.

The problem is that the Minister for Health merely monitors what is happening. This seems to be his forte. He monitors waiting lists and trolley counts, but we need activity in this situation. We do not need the Minister to monitor further. We need him to ensure that the board engages with the nursing organisations to ensure we have an affordable retention fee so that nurses can register and be allowed practise in our public health system. The nurses are threatening to pay just the previous fee of €100. If they do, we will then have a situation where our nurses will no longer be employed by the health services. That is the situation we face.

I suggest it would be easy for the Minister to ensure there is positive engagement between the board, which has unilaterally decided to increase the fee by 50%, and the nursing associations. The board has increased the fee without a meaningful need to do so, other than a bland statement saying it must do so for fitness to practise reasons. Is it that in moving from Fitzwilliam out to Blackrock the nursing board got caught up in the property bubble? We cannot expect nurses who are already under financial pressure to now pay a mandatory increase of 50% on their registration fee. They are not given a choice. If they want to work, they must pay this. It is a form of tax. There is nothing voluntary about the fee and nurses must pay it.

I suggest the Tánaiste should ask her constituency and Cabinet colleague to roll up his sleeves and ask the board to engage meaningfully over the coming weekend in order to bring this issue to a satisfactory conclusion.

The establishment of registration bodies for different groups of professional workers is one that all of the groups have by and large welcomed.

This has been debated from time to time both in this Dáil and previous Dáileanna and Members have been positive towards it. I refer to the registration of teachers and professionals in the social work sector

Are wafflers registered?

Similarly, nursing is a graduate profession which involves significant training and investment by the State and the individuals involved in their education and training. There is strong underlying support for the principle of professional registration, but when the professional registration structures were put in place, it was made clear that the board would be independent and that it would deal with the safeguarding of the professional practice of nurses which has an enormous impact on patient health, safety and the delivery of services.

The Deputy referred to the board having some difficulties-----

It is amazing that the Labour Party takes such a blasé approach to industrial relations.

-----but following discussions with the Department of Health in 2013, it was agreed that a one-off sum of €1.6 million would be granted by the Department to cover costs in 2013-14 on the basis that the board would review its overheads and increase its income in 2015 to meet its commitments under the legislation. The board has, therefore, been significantly assisted by the Department and the Government in addressing the financial issue referred to by the Deputy, but at this point the only way it will be resolved is by further discussions between the parties and them sitting down to resolve it. For the nurses who are working in the health service or who travel abroad to work in other health services, it is important that the registration fee be fair and that the dispute be resolved as soon as possible.

Is the Tánaiste calling on the board to engage directly with nurses?

The Government is cheesing off nurses and teachers.

Will the Tánaiste ask the board to engage directly with nurses?

This issue can be resolved by further discussions and negotiations.

Therefore, Paul Gallagher should engage with them.

That is the appropriate thing to do because the principle of registration is important.